Objective To evaluate Meta-analysis in assessing the overall diagnostic value of adenosine stress echocardiography (ASE) in patients with coronary heart disease (CHD). Methods Relevant English and Chinese articles about ASE for assessing diagnostic accuracy of CHD were collected from the literatures published from 1994 to 2007 in China and abroad. Meta-analysis was conducted with the method recommended by the Cochrane Collaboration. Results Twelve papers were included. The reported sensitivity of ASE for the diagnosis of CHD ranged from 0.69 to 0.94, and the specificity ranged from 0.71 to 1.00. The pooled weighted sensitivity and specificity was 0.81 (95%CI 0.77-0.85) and 0.83 (95%CI 0.78-0.87), respectively;and the pooled positive and negative likelihood ratio was 4.81 (95%CI 3.65-6.33) and 0.22 (95%CI 0.18-0.28), respectively. The area under the curve of the summary receiver operating characteristic was 0.8968±0.0151. Conclusion ASE is medium to highly accurate in the diagnosis of CHD.

Objective To explore the relationship between critical thinking disposition and mental self-supporting and provide reference for educators in an attempt to improve undergraduate nursing students' positive psychological qualities and critical thinking disposition.Methods A total of 406 nursing undergraduates were investigated by using the California Critical Thinking Disposition Inventory-Chinese Version (CCTDI-CV) and Mental Self-supporting Questionnaire of University students.Results Undergraduate nursing students scored (280.91± 28.43) points averagely in critical thinking disposition,and the dimensions of analyticity (42.17±5.31) and truth seeking(37.56±6.42) got the highest and lowest score respectively.The total score of mental self-supporting was 76.40±8.47 points; among the seven subscales,opening and containing(11.90± 1.72) scored the highest and self-conviction(8.87±2.28) scored the lowest.A positive association was found between critical thinking disposition and mental self-supporting(r=0.583,P＜0.01).The regression analysis showed that students' self-decision,self-cognition,self-confidence and self-charge played a significant role in students' critical thinking disposition (R2=0.435,P＜0.01).Conclusion Undergraduate nursing students' disposition of critical thinking and mental self-supporting were on medium level.The subscales of self-decision,self-cognition,self-confidence and self-charge have huge influence on critical thinking disposition.Nursing educators should make an effort in the above 4 aspects so as to improve undergraduate nursing students' critical thinking disposition.

To examine the role of glycogen synthase kinase 3 (GSK-3) in the apoptosis of pancreatic beta-cells to better understand the pathogenesis and to find new approach to the treatment of type 2 diabetes, apoptosis was induced by oleic acid (OA) in INS-1 cells and the activity of GSK-3 was inhibited by LiCl. The PI staining and flow cytometry were employed for the evaluation of apoptosis. The phosphorylation level of GSK-3 was detected by Western blotting. The results showed that OA at 0.4 mmol/L could cause conspicuous apoptosis of INS-1 cells and the activity of GSK-3 was significantly increased. After the treatment with 24 mmol/L of LiCl, a inhibitor of GSK-3, the OA-induced apoptosis of INS-1 cells was lessened and the phosphorylation of GSK-3 was increased remarkably. It is concluded that GSK-3 activation plays an important role in OA-induced apoptosis in pancreatic beta-cells and inhibition of the GSK-3 activity can effectively protect INS-1 cells from the OA-induced apoptosis. Our study provides a new experimental basis and target for the clinical treatment of type-2 diabetes.
Apoptosis/*drug effects ; Cell Line ; Fatty Acids, Nonesterified/*pharmacology ; Glycogen Synthase Kinase 3/*metabolism ; Insulin-Secreting Cells/*cytology ; Oleic Acid/pharmacology ; Phosphorylation

Description of the significance of the team learning theory in building a learning hospital.Building a flat structure in a learning organization, catering to the inherent needs of the hospital and its staff in development, selection of training materials conductive to building common vision of the team, effective and interactive means of training, and team trainings that are objective-specific, level-specific, hatched and focused.All these practices maximize the effectiveness of team learning, bringing forth in the hospital desirable changes in concepts, behavior, culture and performance in the building of a learning hospital

OBJECTIVE: To investigate the relationship between single nucleotide polymorphism of gene and ischemic stroke and search for predisposing genes of ischemic stroke.DATA SOURCES: The Medline database was searched for articles of gene polymorphism of fibrinogen and ischemic stroke published from 1980 to 2005 with the key words of "stroke, plasma fibrinogen, polymorphism"in English. Meanwhile, Vip Information Database was also searched for literatures of gene polymorphism of fibrinogen and schemic stroke published between 1995 and 2005 with the key terms of "ischemic stroke, fibrinogen,gene polymorphism" in Chinese. Full-texts were gotten by correspondence with the authors.STUDY SELECTION: Included literatures were only case control study literatures. Literatures of contrast study, experience summary, individual case and so on were excluded.DATA EXTRACTION: Totally 50 articles of gene polymorphism of fibrinogen and ischemic stroke were retrieved. Twenty articles were accorded with inclusive criteria, and thirty articles were excluded.DATA SYNTHESIS: Level of plasma fibrinogen was co-affected by heredity and environment. Gene polymorphism of fibrinogen has important regulatory effects on the level of plasma fibrinogen. The fibrinogen accelerates thrombotic formation. As a result, the incidence rate of ischemic stroke increased by participating atherosclerosis, helping thrombocytic aggregation and changing the status of hemorheology. But definite mechanism and molecular function of gene polymorphism of fibrinogen deserved further research.CONCLUSION: The relationship between single nucleotide polymorphism of fibrinogen and ischemic stroke remains obscure. It also needs further study.

Objective To discuss the effect of continuing nursing care on patients with rheumatoid arthritis. Methods 117 patients with rheumatoid arthritis were divided into the control group (60 pa-tients) and the experimental group(57 patients). The control group adopted clinic follow-up visit and rou-tine responding measures. The experimental group was given knowledge education according to the ASMP course, which included demonstration,nurse-patient communication,communication between patients, video show, telephone follow-up and support, etc. The degree of pain,cognition degree of disease knowledge, fre-quency of physical exercises,compliance with doctor's advice, readmission rate and self-care ability of pa-tients with joint deformity were compared by χ2 test between the two groups. Results The experimental group was superior to the control group in the following aspects, such as degree of pain,cognition degree of disease knowledge, frequency of physical exercises,compliance with doctor's advice, readmission rate and self-care ability. Conclusions Application of continuing nursing care in patients with rheumatoid arthri-tis contribute to the prognosis of patients.

BACKGROUND:The effect of placenta-derived growth factor(PLGF)on promoting vascular regeneration remains uncertain.In studies of models with PLGF deletion,PLGF has been considered to play critical role in inducing angiogenesis.OBJECTIVE:To summarize the research advances in effect of PLGF and its receptor in vascular regeneration and ischemic cerebral disease.METHODS:A computer-based online search of Pubmed and CNKl was performed for relevant articles published between 1990 and 2009 with key words of"PLGF"in Chinese and"PLGF angiogensis"Articles related with biological characteristics of PLGF and its roles in vascular regeneration and articles related with angiogenesis and PLGF expression after cerebral ischemia were selected.Repetitive articles were excludedRESULTS AND CONCLUSION:The role of PLGF and its receptor in vascular regeneration,mechanism of PLGF and its receptor to promote angiogenesis,vascular endothelial growth factor A,and the expression of PLGF and its receptor in brain after cerebral ischemia were introduced.PLGF can promote pathological angiogenesis,arteriogenesis,branch formation and hemopoietic progenitor cell mobilization.PLGF and its receptor play an important role in the angiogenesis of ischemic cerebral disease and display a good clinical prospect in the treatment of ischemic cerebral disease However,the specific role and mechanism require further study.

OBJECTIVE:To establish a method for the simultaneous determination of chlorogenic acid,evodiamine,rutecar-pine in different places of Evodia rutaecarpa. METHODS:UPLC was performed on the column of ACQUITY UPLC BEH C18 with mobile phase of acetonitrile-0.1% Phosphoric acid aqueous solution(gradient elution)at a flow rate of 0.40 ml/min,the detection wavelength was 326 nm and 220 nm,column temperature was 30 ℃,and the volume injection was 2 μl. RESULTS:The linear range was 7.67-76.67 μg/ml for chlorogenic acid(r=0.999 2),13.33-133.33 μg/ml for evodiamine(r=0.999 7)and 13.33-133.33μg/ml for rutecarpine(r=0.999 8);the limits of quantitation were 0.11 ng,0.05 ng and 0.05 ng,the limits of detection were 0.03 ng,0.01 ng and 0.01 ng,respectively;RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 96.19%-101.90%(RSD=2.19%,n=6),95.35%-101.16%(RSD=2.27%,n=6)and 95.92%-98.98%(RSD=1.33%,n=6),re-spectively. CONCLUSIONS:The method is rapid and accurate,and suitable for the simultaneous determination of chlorogenic ac-id,evodiamine,rutecarpine in different places of E. rutaecarpa.

Dystrophinopathies are a group of fatal X chromosome recessive genetic disease. With the application of ventilator technolo-gy, the main causes of death in patients with dystrophinopathies turned from respiratory failure into circulatory failure, and the importance of heart problems has become increasingly prominent. Myocardial damage can be defined with myocardial enzymes, electrocardiogram, ul-trasound cardiogram, cardiac magnetic resonance imaging, etc. Drugs for chronic heart failure remain the most important strategy, and heart transplant or left ventricular assist devices implant may be the alternatives for those in the end.